Citation Information :
Paul A, Bhargava A, Gupta RK, Malhotra P, Singh M, Dua B. Stress Transmission on Bone and Prosthetic Screws Influenced by Implant Position: A Finite Element Analysis. Int J Prosthodont Restor Dent 2024; 14 (1):45-49.
Purpose: To evaluate stress on bone and prosthetic screws as influenced by varying implant positions in a six-implant supported mandibular hybrid prosthesis using finite element method (FEM).
Materials and methods: Three-dimensional (3D) models of the human mandible were generated. Three different models were created with 4.2 × 11.5 mm implants placed in different regions bilaterally (model 1: first premolar, second premolar, first molar region; model 2: central incisor, canine, first molar region; model 3: central incisor, second premolar, first molar region). A structural steel framework of 6 mm width to which the abutments were connected was also simulated. To carry out dynamic loading, all the models were subjected to a load of 150 N at 75° on the canine region and first molar region over 3,000,000 cycles, which simulated a clinical usage of 10 years. Stress analysis was carried out under dynamic loading using finite element software (ANSYS Inc.).
Results: In model 1, maximum stress was induced on the prosthetic screw over the implant placed in the first premolar region, which fractures within 2,100,000 cycles (representing a clinical usage of 7 years). In model 3, the maximum stress was induced on the prosthetic screw over the implant placed in the central incisor region, which fractures within 2,400,000 cycles (representing a clinical usage of 8 years). No significant deleterious stress was seen to be induced on the bone.
Conclusion: The screws fracture within a period of 7–8 years when the implants are placed in a less-than-ideal position, but owing to the prudent variation in a patient's mouth, it can be concluded that prosthetic screws in a full arch prosthesis should be changed within a period of 3–5 years, irrespective of the number of implants. Even though our results suggested that not much impact is induced in the bone, in a clinical scenario, this may vary where bone can increase and decrease in density in order to react and adapt to stress; thus, further clinical studies need to be carried out for the same.
Meriç G, Erkmen E, Kurt A, et al. Influence of prosthesis type and material on the stress distribution in bone around implants: a 3-dimensional finite element analysis. J Dent Sci 2011;6(1):25–32. DOI: 10.1016/j.jds.2011.02.005
Chang HS, Chen YC, Hsieh YD, et al. Stress distribution of two commercial dental implant systems: a three-dimensional finite element analysis. J Dent Sci 2013;8(3):261–271. DOI: 10.1016/j.jds.2012.04.006
Sharaf MA, Wang S, Mashrah MA, et al. Outcomes that may affect implant and prosthesis survival and complications in maxillary fixed prosthesis supported by four or six implants: a systematic review and meta-analysis. Heliyon 2024;10(3):e24365. DOI: 10.1016/j.heliyon.2024.e24365
Pandey A, Durrani F, Rai SK, et al. Comparison between all-on-four and all-on-six treatment concepts on stress distribution for full-mouth rehabilitation using three-dimensional finite element analysis: a biomechanical study. J Indian Soc Periodontol 2023;27(2):180–188. DOI: 10.4103/jisp.jisp_278_22
das Neves FD, Verissimo AG, da Silva Neto JP, et al. Photoelastic stress analysis of different wide implant/abutment interfaces under oblique loading. Int J Oral Maxillofac Implants 2013;28(1):e39–e44. DOI: 10.11607/jomi.2157
Alkan I, Sertgöz A, Ekici B. Influence of occlusal forces on stress distribution in preloaded dental implant screws. J Prosthet Dent 2004;91(4):319–325. DOI: 10.1016/j.prosdent.2004.01.016
Oh JH, Kim YS, Lim JY, et al. Stress distribution on the prosthetic screws in the all-on-4 concept: a three-dimensional finite element analysis. J Oral Implantol 2020;46(1):3–12. DOI: 10.1563/aaid-joi-D-19-00090
Vaidyanathan AK, Banu RF. Finite element analysis - concepts for knowledge and implementation in dental research. J Indian Prosthodont Soc 2022;22(3):211–214. DOI: 10.4103/jips.jips_299_22
Lai YS, Chen WC, Huang CH, et al. The effect of graft strength on knee laxity and graft in-situ forces after posterior cruciate ligament reconstruction. PLoS One 2015;10(5):e0127293. DOI: 10.1371/journal.pone.0127293
Kumari A, Malhotra P, Phogat S, et al. A finite element analysis to study the stress distribution on distal implants in an all-on-four situation in atrophic maxilla as affected by the tilt of the implants and varying cantilever lengths. J Indian Prosthodont Soc 2020;20(4):409–416. DOI: 10.4103/jips.jips_70_20
Iniyan N, Kulkarni D, Lourenço S. Pre-operative simulation of implant angulation effect on mandibular masticatory stresses-a finite element study. Procedia Eng 2013;64:815–824. DOI: 10.1016/j.proeng.2013.09.157
Khraisat A, Stegaroiu R, Nomura S, et al. Fatigue resistance of two implant/abutment joint designs. J Prosthet Dent 2002;88(6):604–610. DOI: 10.1067/mpr.2002.129384
Bramanti E, Cervino G, Lauritano F, et al. FEM and Von Mises analysis on prosthetic crowns structural elements: evaluation of different applied materials. Scientific World Journal 2017;2017:1029574. DOI: 10.1155/2017/1029574
Singh M, Bhargava A, Nagpal A, et al. Evaluation of physical changes due to simulated loading on prosthetic screw supporting 4- and 6-unit implant prosthesis: an in vitro study. J Indian Prosthodont Soc 2022;22(4):389–397. DOI: 10.4103/jips.jips_48_22
Yemineni BC, Mahendra J, Nasina J, et al. Evaluation of maximum principal stress, Von Mises stress, and deformation on surrounding mandibular bone during insertion of an implant: a three-dimensional finite element study. Cureus 2020;12(7):e9430. DOI: 10.7759/cureus.9430
Goodacre CJ, Bernal G, Rungcharassaeng K, et al. Clinical complications with implants and implant prostheses. J Prosthet Dent 2003;90(2):121–132. DOI: 10.1016/S0022-3913(03)00212-9
Gonzalez-Gonzalez I, deLlanos-Lanchares H, Brizuela-Velasco A, et al. Complications of fixed full-arch implant-supported metal-ceramic prostheses. Int J Environ Res Public Health 2020;17(12). DOI: 10.3390/ijerph17124250
Weinberg LA. Reduction of implant loading with therapeutic biomechanics. Implant Dent 1998;7(4):277–285. DOI: 10.1097/00008505-199807040-00005
Vinayak S, Froum SJ, Liu K, et al. A novel surgical aid to achieve optimal positioning of adjacent implants in fully edentulous mandibular cases. Compend Contin Educ Dent 2019;40(10):668–676. PMID: 31730364.
Gao J, Li X, He J, et al. The effect of mandibular flexure on the design of implant-supported fixed restorations of different facial types under two loading conditions by three-dimensional finite element analysis. Front Bioeng Biotechnol 2022;10:928656. DOI: 10.3389/fbioe.2022.928656
Padhye OV, Herekar M, Patil V, et al. Stress distribution in bone and implants in mandibular 6-implant-supported cantilevered fixed prosthesis: a 3D finite element study. Implant Dent 2015;24(6):680–685. DOI: 10.1097/ID.0000000000000300
Zarone F, Apicella A, Nicolais L, et al. Mandibular flexure and stress build-up in mandibular full-arch fixed prostheses supported by osseointegrated implants. Clin Oral Implants Res 2003;14(1):103–114. DOI: 10.1034/j.1600-0501.2003.140114.x
Shahriari S, Parandakh A, Khani MM, et al. The effect of mandibular flexure on stress distribution in the all-on-4 treated edentulous mandible: a comparative finite-element study based on mechanostat theory. J Long Term Eff Med Implants 2019;29(1):79–86. DOI: 10.1615/JLongTermEffMedImplants.2019030866
